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A Man's Runny Nose Turned Out to Be His Brain Leaking Cerebral Fluid

Greg Phillpotts's runny nose was like an unpredictable tap, draining at random on airplanes, during conversations and even into his Thanksgiving dinner. He put the problem down to allergies, until doctors alerted him it wasn’t his nose that was leaking but his brain.

The grandfather from Johnston County, North Carolina, struggled with a dripping nose for five years. Doctors couldn’t put their finger on the problem, pinning it to conditions as wide-ranging as pneumonia and bronchitis, he told WTVD.

In February, his symptoms worsened and he was kept awake all night coughing.

Dr Alfred Iloreta, an ear, nose and throat specialist at Mount Sinai Hospital in New York, got to the bottom of Phillpotts’s condition and diagnosed him with a cerebrospinal fluid leak.

To treat Phillpotts, doctors took a flap of tissue from another part of his body to plug the leak. The grandfather spoke of the “relief” he felt at being able to breathe properly again.

According to Johns Hopkins University, a leak can occur when the liquid that circulates the ventricles of the brain and around the spinal cord break into the skull, through the ear or nose, or a part of the brain called the dura. This can be triggered by damage to the brain caused by surgery or head injuries.

At least five in 100,000 people experience cerebrospinal fluid leaks worldwide each year, according to the CSF Leak Association. Symptoms include headaches, a runny nose, visual disturbances and tinnitus. The condition can therefore easily be misdiagnosed. A cerebrospinal fluid leak can also heighten a person’s risk of developing potentially deadly meningitis.

Dr. Iloreta explained the problem can develop into what is known as an ascending infection, enabling bacteria to "travel from the nose to the brain resulting in meningitis."

Earlier this year, Kendra Jackson of Omaha, Nebraska similarly discovered what she thought were allergies were in fact a cerebrospinal fluid leak.

Commenting on Jackson’s case at the time, Dr Brad Marple, chair of otolaryngology at the University of Texas Southwestern’s Peter O’Donnell Jr. Brain Institute, told Newsweek: “This fluid serves the function of providing mechanical protection of the brain through cushioning or buffering, as well as playing a role in its immunologic protection.”

“Normally, it is contained within the water-tight confines of the skull, but occasionally an area of disruption can develop between the intracranial cavity and air-filled spaces within the skull. The sinuses are examples of air-filled spaces within the skull that share a thin common wall with the intracranial cavity and serve as a common route for a CSF leak. Under these circumstances, CSF can drip from the nose and be mistaken for a runny nose.”

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